Osteopathic Manual Treatment Offers Short-Term Relief of Chronic Low Back Pain, Ultrasound Therapy Does Not

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With low back pain responsible for more than 20 million office visits and $100 billion dollars in health care costs annually in the United States, researchers examine the efficacy of osteopathic manual treatment and ultrasound therapy in the largest such trial ever conducted.

The randomized controlled trial involving 455 patients with chronic low back pain found OMT offered effective short-term pain relief; by contrast, ultrasound therapy was not effective in relieving patients' chronic low back pain. Randomizing patients to receive OMT (n=230), sham OMT (n=225), UST (n=233) or sham UST (n=222) for six treatment sessions over eight weeks, the researchers found 145 (63 percent) OMT patients vs. 103 (46 percent) sham OMT patients reported moderate improvement at week 12.

Similarly, 114 (50 percent) OMT patients vs. 79 (35 percent) sham OMT patients reported substantial improvement. By contrast, moderate improvement was observed in 128 (55 percent) UST patients vs. 120 (54 percent) sham UST patients. Substantial improvement was observed in 103 (44 percent) UST patients vs. 90 (41 percent) sham UST patients.

The OMT treatment effects met or exceeded the Cochrane Back Review Group criterion for a medium size effect for both moderate and substantial improvements in low back pain, making the findings clinically relevant. The authors add that the less frequent use of drugs for low back pain reported by OMT patients further corroborates the clinical relevance of the findings.

They assert these results may begin to explain why one-third of ambulatory, chronic problem visits for low back pain in the United States are provided by osteopathic physicians and why they less frequently prescribe medications, such as nonsteroidal anti-inflammatory drugs, than allopathic physicians during such visits.

Because the OMT regimen was found to be effective, safe, parsimonious and well accepted by patients, the authors call for a larger trial to assess the efficacy and cost-effectiveness of OMT at long-term endpoints.

Osteopathic Manual Treatment and Ultrasound Therapy for Chronic Low Back Pain: A Randomized Controlled Trial, By John C. Licciardone, DO, MS, MBA, et al, The Osteopathic Research Center, University of North Texas Health Science Center, Fort Worth, Texas